In the world of pediatrics, each day is an adventure. The human body is complex and wonderful. Many medical problems are based on something easily identified. Ear infections and appendicitis come to mind. But there is more than enough complexity to the body to make the obvious, well, less obvious. An ear infection may be only a surface finding of something more complicated. Appendicitis may be so much more, or less, than appendicitis.
At Quinte Pediatrics and Adolescent Medicine, we are often asked whether teething in infants and toddlers may cause fever, rash, diarrhea or other symptoms that look like infection. Just as often, parents bring their young one to the office with certain signs of infection, only to discover the young one does not actually have an ear infection, or virus, or other infection.
How to make sense of teething? Here’s what the medical literature has to say. This is taken from the journal Pediatrics, one of the pre-eminent publications in the world of pediatrics:
Pediatrics Vol. 105 No. 4 April 1, 2000, pp. 747 -752
“The strongest associated symptoms (of teething) were biting, drooling, gum-rubbing, irritability, and sucking, which occurred with greater frequency during the 4 days before and up to 3 days after a tooth emergence.
Symptoms that increased in frequency only on the same day and or a day or 2 before a tooth emergence included decreased appetite for solids, wakefulness, ear-rubbing, facial rash, and abnormal temperature.
Symptoms that showed no significant associations with teething were decreased appetite for liquids, cough, rash other than facial rash, and temperature greater than 102°F.”
Treatment of symptoms of teething is not automatically necessary, as symptoms are self-limited, and resolve with emergence of the tooth. When help is needed, however, focus on comfort by cooling your finger with an ice cube and then running your finger gently over the gums. Topical analgesics such as Oragel (I have no commercial interest, and this is not a sponsored endorsement!) may be helpful – apply a small amount to your finger and hold it directly on the area of the gum that seems most painful, for 10 seconds or so. And oral anti-inflammatories, such as acetaminophen or ibuprofen, may be helpful as well. Always refer to the bottle for the right dose for your loved one.
And, as always, if your parental radar tells you something just isn’t right, don’t hesitate to talk to your doctor.
– Dr. G Paul Dempsey